3. Indian Penal Code (IPC, 1860)
Section 312
Any one voluntarily causing miscarriage to a woman with
child, other than in good faith for the purpose of saving
her
life is punishable by imprisonment (simple or rigorous)
&/or a fine
Sections 313 - 316 (for death due to procedure)
Up to 10 years imprisonment and fine, extending up to life
imprisonment where the abortion was conducted without
consent
5. A Protective Umbrella
The MTP Act if adhered to completely offers
complete protection to the medical practitioner from
any of the consequences of the IPC
However legal protection is only available
conditional to every requirement of the Act being
fulfilled
Sheriar, J Obs Gyn India, 51(6):25, 2002
6. The MTP Act (Act No. 34 of 1971)
“ An Act to provide for the Termination of certain
pregnancies by registered medical practioners & for
matters connected therewith & incidental thereto”
Legislated by the Parliament on August 10th
, 1971
And the Act was enforced Nationwide from April 1st
,
1972
Adopted by Kashmir & Mizoram- 1980
7. MTP Act, Rules, Regulations
MTP Act Is an Act of Parliament providing an
Overview of Safe abortions and delegating authority
to Central & State government
Rules are framed by the Central Government BUT
must be ratified by each house of Parliament
Regulations are framed by the State Government &
relate to issues involving Opinions , reporting and
maintaining secrecy
10. MTP Act Specifies:
1 The Indications for legal Terminations
2 Who can Terminate
3 The Place where it can be terminated
4 Last but most imp. Consent requirement
11. When pregnancy can be terminated.. ???
1--continuation of pregnancy is a risk to the life of
pregnant woman
or
it can cause grave injury to her physical and mental
health
2--Substantial risk that the child , if born ,would be
seriously handicapped due to physical or mental
abnormalities
3--pregnancy caused by rape
4--failure of contraceptive in married woman
13. Who can perform MTP ?
A Registered Medical practitioner (RMP )who has a
recognized Medical qualification as defined in clause
( b) of Sec 2 of indian Medical Counsel Act, 1956
Whose name is registered in a state Medical register
Who has training experience as per MTP rules
14. Experience of RMP-
Up to 12 weeks Gestation only
Before the commencement of act experience
minimum 3yrs
Who is regst in state medical register ---6months of
house surgeon ship in gynae
Or experience of working in dept of gynae –1yr
1-- A Practitioner who has assisted RMP in 25 cases of
Medical termination of pregnancies ,at least 5 of
which have been performed independently in a
hospital established or maintained by govt or a
training institute approved for this purpose by the
Govt
15. Experience and Training Required by a
RMP-upto 20 wks
PG Degree or Diploma in OB & Gynae
Completed 6 months as House Surgeon in OB &
Gynae
At least one yr experience in dept of ob & Gynae at
any hospital that has all facilities
16. Where pregnancy can be Terminated --
PLACE
Hospitals established or maintained by the Govt
A Place approved by the Government or DLC
constituted by the Govt
17. Consent ----- Form C
1-- Only the
consent of a
women is
required
2-- If Age <18 yrs
or a mentally ill
patient consent of
guardian is reqd
18.
19. MTP Rules
A- Appointed by Govt n responsible for approval and
suspension of Place
Chaired by CMO
B 3-5 members
C - one member shd be Gynecologist , surgeon ,
Anesthetist
D -other members are from local drs , NGO,
Panchayat Raj
E -at least one should be woman
1---Composition and tenure of DLC Which is
20. Up to 12 wks --
FACILITIES -
1-Gynecological examination /labor table
2-Resuscitation and sterilization Equipments
3-Drugs and Parenteral fluids
4- Backup facilities for treatment of shock
2- REQUIREMENT FOR
APPROVAL OF A PLACE
MTP rules ….
21. …For approval
For Terminating 12 to 20 weeks of Pregnancy
FACILITIES
1-An operation table and instruments for performing
abdominal or gynecological surgery
2-Anesthetic Equipments, resuscitation and
sterilization equipments
3- Drugs and Parentral fluids for any emergency ,
notified by GOI from time to time
25. Inspection of Place
Place should be inspected within 60 days of receipt
of approval
and approval within next 2 months or within 2 month
of any deficiency being rectified by applicant to
ensure safe and hygienic conditions
CMO may inspect the approved place any time if
necessary to reconfirm
You have to show and give all information's to CMO
anytime
29. Amendments to MTP rules 2003
Key features :-
1. Detailed the composition and tenure of the DLC
2.Abortion sites approved for
A- up to 12 weeks
B- 12-20 weeks, facilities and equipments required for
two types were detailed
3.Allowed medical abortion using RU-486 and
misoprostol by RMP even from site not approved
provided the RMP has referral linkage access to an
approved place
4.A non OB gynae provider who is trained and certified
can provide first trimester abortion
32. Maintenance Of Admission
Register
Maintain records As per Form III ( Annexure -4 )
Record the detail
Keep in secret custody for 5 years from the end of
calendar year it relates to; It is not disclosed to
anyone except under authority of law
33.
34. Recommendations to Overcome Shortcomings
Requirement of 2 opinions for second trimester
termination is now a formality and could be dispensed
A qualified extension of up to 22 weeks to
accommodate terminations after prenatal diagnosis of
birth defects
Scope to simplify and streamline bureaucratic
procedures by amending MTP Rules and Regulations.
Registration of centres by meticulous application &
persistent follow up
Valid case for bifurcating recognition requirements for
performing first & second trimester MTPs, in view of
the documented safety & simplicity of early abortions
35. Recommendations to Overcome Shortcomings
With medical methods administered on an outpatient
basis, the act needs to be updated to keep abreast with
future medical advances
Revisit documentation required. Admission register
could be replaced by MTP Register
Increase the number of trained persons performing
induced abortions by multiplying training facilities
36. Violation of The ACT
Any person doing MTP and not a RMP can be
punished with rigorous imprisonment for 2-7 yrs
If terminating at a place which is not approved
can be punished 2--7 yrs rigorous imprisonment
The owner of unapproved place , performing
termination can also be punished with rigorous
imprisonment 2--7 yrs
37. Legal abortion means
Termination done at a place approved under the Act
Termination done for conditions and within the
gestation prescribed the Act
Termination done by a medical practitioner approved
by the act
Other requirements of the rules and regulations are
complied with
38. Take home message
• It is necessary to do register your nursing home
under the MTP act, if you are going to do MTP
• Must follow all the rules and regulations under
MTP strictly and correctly
• All paper work must be complete before you start
an MTP ,one never knows when an emergency
arises
• Cultivate good habits like keeping and preparing
documents well in time .
39. In matters of style, swim with the current;
in matters of principle, stand like a rock.
